Cody Dylan Kern

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

2024027523 Issued in MO

Practice address

1723 Broadway St Ste 315
Cape Girardeau, MO 63701-4556

Phone

(573) 334-4822

NPI assigned

Mar 23, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

GastroenterologyAlso: Internal Medicine

Education

University of Missouri, Columbia School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Missouri Hospital Physicians LLCGroup PAC ID 9133024334, 206 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110
• Mercy Hospital Stoddard Hospital, Dexter, MO, CCN 260160
• Mercy Hospital Perry Hospital, Perryville, MO, CCN 261311

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ckern33669@ukhcdirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southeast Missouri Hospital Physicians, LLC

  • Family Medicine Physician
  • Cape Girardeau, MO
  • NPI 1558311522

  Gastroenterology

  Medicare reassignment Care Compare group NPD
• Uk Healthcare

  • General Acute Care Hospital
  • Lexington, KY
  • NPI 1902214448
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Perry

  • Critical Access Hospital
  • Perryville, MO
  • NPI 1063117158
  Care Compare affiliation
• Southeast Health Center of Stoddard County, LLC

  • General Acute Care Hospital
  • Dexter, MO
  • NPI 1801990825
  Care Compare affiliation
• Southeast Hospital

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1811006661
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1184128118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 BROADWAY ST STE 315",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014556",
            "telephone_number": "573-334-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 BROADWAY ST STE 315",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014556",
            "telephone_number": "573-334-4822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERN",
        "first_name": "CODY",
        "middle_name": "DYLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-23",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2024027523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Ann Kennedy
• Jacquelyn Malia Kennedy
• Olivia Ann Kennedy, DO
• Patrick B Kennedy, PTA
• Kenneth a Decoursey, MD PC
• Jon-Erik W Kern, PTA
• Scott Thomas Kernan
• Deborah Lucille Kerr, PH.D.
• Melissa Rene Kerr, PHARM. D.
• Kessinger Upper Cervical Care Clinic, LLC

• Gastroenterology Physician in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Gastroenterology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.